AI UPDATE: USAID/FAO VISITORS REVIEW BURMA EFFORTS

UNCLAS SECTION 01 OF 04 RANGOON 000203 SIPDIS STATE FOR EAP/MLS; USDA FOR FAS/PECAD, FAS/CNMP, FAS/AAD; BANGKOK FOR USAID/RDMA: JMACARTHUR, APHIS: NCARDENAS, REO: JWALLER; PACOM FOR FPA SENSITIVE SIPDIS E.O. 12958: N/A TAGS: EAGR EAID AMED PGOV CASC TBIO KLFU BM SUBJECT: AI UPDATE: USAID/FAO VISITORS REVIEW BURMA EFFORTS REF: A) 06 RANGOON 1776, B) RANGOON 1679 RANGOON 00000203 001.2 OF 004 ¶1. (U) Summary: Burma has not reported any new cases of AI since it contained a March-April 2006 outbreak in poultry in Mandalay and Sagaing Divisions through extensive culling. Recent sero surveillance detected AI antibodies in ducks in Mandalay and Bago Divisions, but examination by GOB, USAID and FAO specialists showed levels below those set by OIE, and further tests proved negative. FAO's Regional Avian Influenza advisor carried samples from Mandalay to Thailand for testing, but said she was confident that the poultry does not have H5N1. Visitors from FAO and USAID RDMA in Bangkok reported improved monitoring and continued cooperation and transparency from GOB health/veterinary contacts, but expressed concern about poor lab infrastructure, inadequate skills training, lack of AI awareness in rural areas, and the continued commingling of poultry with humans and other livestock in many parts of the country. End summary. Good News: Duck Follow-Up Tests Negative -------------- ¶2. (SBU) GOB officials provided useful updates on AI efforts in Burma during the February 12 - 17 visits of USAID Infectious Diseases Team Leader, Dr. John MacArthur, USAID Animal Health Advisor Dr. Sudarat Damrongwatanapokin, and FAO Regional AI Advisor Dr. Wantanee Kalpradith. The GOB requested FAO assistance to evaluate samples collected from ducks that tested positive for H5N1 during regular sero surveillance in Mandalay and Bago Divisions. Dr. Sudarat worked closely with Livestock Breeding and Veterinary (LBVD) officials in their lab and made a field trip to Bago to investigate further. ¶3. (SBU) On February 14, Dr. Sudarat told Charge that the levels of AI antibodies in the samples were below the OIE cutoff for a positive results, which signaled that the ducks could have been exposed to the disease during the 2006 outbreak or that the test was detecting a non-H5 sub- type of avian influenza. In other samples that met the OIE criteria for a positive test, LBVD laboratory analysis did not detect any virus. Dr. Sudarat expressed confidence that the ducks do not have AI, based on the lack of clinical signs associated with both the ducks and neighboring chickens. On February 15, FAO carried additional samples from ducks in Mandalay to the Department of Animal Health in Bangkok for further evaluation. Facing Inadequacies -------------- ¶4. (SBU) Dr. Sudarat praised the level of GOB openness and transparency that she and the FAO team found during their latest visit. She also noted that officials observed good protocol in handling the specimens and showed the benefit of previous training. She added, however, that, in many areas, official capabilities are still inadequate, including poor quality of labs, unreliable power supply, inconsistent results, and inadequate skills training. ¶5. (U) In a February 14 meeting led by LBVD Director General, Dr. Maung Maung Nyunt, Dr. Suadarat made the following recommendations to address some of Burma's inadequacies: create an inventory list of lab supplies; collect at least 60 samples from each flock; provide more regular electric power to labs; follow international standards for testing; increase reliance on sero surveillance; provide more training for staff; monitor egg age for virus isolation; increase surveillance in wetlands; concentrate more surveillance in high risk areas; and expand H5N1 testing to quail, if possible. The DG added other areas of concern, including the negative effect of quail egg exports to India, which he claimed reached up to RANGOON 00000203 002.2 OF 004 1 million eggs a day; problems reaching many remote areas, including a jade mining town of 300,000 which he called a "hidden city;" lack of funding for a livestock compensation program; and the relatively small number of international donors. ¶6. (U) According to the DG, GOB current priorities are: strict biosecurity on farms, reducing range of birds, reduced contact with live bird markets, disease monitoring and reporting, and open information exchange. But Progress in Assistance to Farmers -------------- ¶7. (U) In a formal presentation and lively discussion with Drs. MacArthur, Sudarat and emboffs, the DG claimed the GOB had made a great deal of progress in its response to AI. He noted the ongoing sero surveillance conducted at village homes, farms, markets, hatcheries, and wild bird sanctuaries. He described new programs to reduce the impact on farmers affected by extensive culling during the outbreak. These include the allocation of 93 acres in Sagaing Division for "Livestock Zones," outside of village limits, where farmers with at least 500 chickens received free leases, telephone connections, tube wells, subsidized electricity, and day old chicks to restock their flocks. LBVD has already distributed to farmers almost 100,000 chicks out of a target total of almost 264,000. Farmers unaffected by the earlier culling also can build farms in the Livestock Zones, but must pay for the lease and services provided. ¶8. (U) In addition, according to the DG, the Livestock and Fisheries Development Bank has begun to offer loans to farmers at the concessional annual rate of 17% (less than half the current market rate in Burma),renewable yearly. He noted that these loans, in contrast to regular loans, do not need to be secured by immovable property. The DG said the GOB also provided some farmers with cell phone permits which they could then resell at a profit. The DG emphasized that these efforts were not a compensation plan for the farmers, but "in-kind help" and "restocking" to mitigate damage. The GOB cannot afford to replicate this plan in the future, he said, because few international donors had offered support. ¶9. (U) Dr. MacArthur suggested expanding LBVD's Livestock Zones to include farms of 200 chickens or more, noting that the outbreak primarily affected farms with 200-500 chickens. He also encouraged LBVD to learn whether farmers thought the current government support provided enough incentive for them to report any future outbreak. He also mentioned that two LBVD laboratory technicians could receive one month of funded AI training at Thailand's National Institute of Animal Health and encouraged LBVD to pursue this. ¶10. (U) The government has upgraded lab facilities, the DG reported, and now has three labs, in Rangoon, Mandalay and Taunggyi, that can perform serology testing for AI. According to the DG, the GOB will also build a central testing lab near Mandalay in 2008. Dr. Sudarat offered to provide guidance on lab construction, based on Thai experience. How Widespread Is AI Awareness? -------------- ¶11. (U) According to the DG, awareness of the potential threat of AI is now widespread among the people, including farmers. He credited publicity sponsored by the GOB, JICA, FAO, AusAID, UNICEF, and WHO. Every Township has organized a team with members of the local poultry association, General Administration officials and other local RANGOON 00000203 003.2 OF 004 authorities, police, municipal authorities, government veterinarians and health officials. He also noted that USDA (the regime's political mass member organization) members, Special Branch officers, and police investigators work with local authorities to ensure regular reporting. The DG cited recent official reporting and swift response to the death of five sparrows in Chin State as an example of countrywide awareness. ¶12. (SBU) WHO officials confirmed that township coordinating teams are in operation, but noted that on their trips around the country, they have observed few public notices or signs warning about AI, even in high risk areas close to Rangoon, such as Moyingyi wetlands in Bago Division. The WHO Country Representative, Prof. Adik Wibowo, expressed concern about the low level of awareness around the country. She told us that her AI Team has worked primarily with central government and state/division-level officials, and will soon begin to focus on more communication and coordination with township, district, and village authorities as well. Hospital Upgrades, Training and Communications -------------- - ¶13. (SBU) At WHO, Professor Wibowo informed Dr. MacArthur that the Japanese Trust Fund plans to provide $98,000 to finance infrastructure renovations, to include isolation wards and new ventilation systems, at each of the two hospitals designated as primary AI care facilities, Waibagi and Kandunadi. Wibowo said the Ministry of Health agreed to upgrade facilities at seven state/division hospitals. WHO hopes to use World Bank Trust Fund money for these projects, she said. WHO also plans to conduct training and capacity building for AI detection and reporting at all 17 state/division hospitals and recently concluded training of Rapid Response Teams at the state/division level. WHO will now move to township-level training for early AI warning systems. ¶14. (SBU) Wibowo said she has open, regular communication on AI with Ministry of Health authorities. She told us that Ministry of Health officials immediately informed her about the positive results from sero sampling of ducks, although she had not previously heard about the sparrows in Chin State. On February 21, Ministry of Health contacts also told her about 15 crows found dead in Rangoon Division, which tested positive for an H-type virus, but negative for H5N1. The Ministry of Health and LBVD conducted an investigation, including at the local wet market, and sent samples to Bangkok for further examination. Foreign Assistance Put to Use -------------- ¶15. (U) At FAO, Country Representative Tang Zhengping told Dr. MacArthur that FAO's USAID-funded activities will begin in March 2007, and will end by October. FAO has hired six national consultants and placed an FAO veterinarian at LBVD (reftels). He said that the World Bank had agreed to provide $1.3 million to FAO. ¶16. (U) At UNICEF, Communication Officer Susan Aitkin informed us that the Japanese Trust Fund (JTF) had extended its $2.1 million Public Awareness/Risk Communication grant deadline from March 2007 to March 2008. Aitkin described the working group for public awareness messages, which includes the Ministry of Health, LBVD, international NGOs, FAO, and WHO. The Minister of Health exercises final approval and all partners will use communally developed materials. On February 23, UNICEF delivered the first posters and pamphlets funded by the JTF grant to the GOB for distribution through LBVD and Health Department offices RANGOON 00000203 004.2 OF 004 in all townships. ¶17. (U) Dr. MacArthur and emboff visited the Central Epidemiology Unit (CEU) of the Ministry of Health to observe CEU storage of Personal Protective Equipment (PPE) units. Twenty-five units were stored in the CEU's meeting room; however, since the CEU will soon relocate to Nay Pyi Taw, the GOB plans to move the PPEs to another location in Rangoon to remain close to epidemiologic investigation teams based here. ¶18. (SBU) All IOs and INGOs praised the GOB's coordination, cooperation, and openness with the international community on AI. Government officials reported immediately the questionable blood test results found during routine surveillance and requested outside assistance without delay. USAID and FAO visitors and post's APHIS employee were given access to laboratories and officials promptly. The response to sparrows that died in Chin State - alerting authorities, isolating the birds and area, conducting post mortem examinations and making final notifications - followed all recommended procedures. ¶19. (SBU) Comment: Despite modest resources, the GOB has implemented AI surveillance, awareness, and reporting programs broadly and quickly. The regime has long experience dictating orders from the center, tasking relevant officials, as well as security officials, to ensure compliance and reporting. However, its track record is weak with regard to ensuring accurate information gets transmitted back up the chain. It also does not usually explain why its orders must be followed, so internationally-supported education campaigns will be needed to inform villagers why precautions must be taken to minimize the threat of AI. In addition, regular visits by UN agencies and international donors at local levels can provide confirmation that accurate information is getting reported back up the chain. End comment. ¶20. (U) Dr. John MacArthur cleared this cable. VILLAROSA